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Biomedical subjects

J R Anderson

Publications and source records attributed to J R Anderson.

At least 271 records · Page 15Linked to original sources
PubMed1990

A randomized comparison of methotrexate dose and the addition of bleomycin to CHOP therapy for diffuse large cell lymphoma and other non-Hodgkin's lymphomas. Cancer and Leukemia Group B study 7851.

In 1978, Cancer and Leukemia Group B initiated a randomized study to determine the usefulness of the addition of bleomycin and/or high-dose methotrexate to standard therapy for the treatment of certain adult non-Hodgkin's lymphomas. Between 1978 and 1985, 177 patients with diffuse large cell lymphoma (DLCL) and 97 patients with other intermediate-grade non-Hodgkin's lymphoma were randomized to receive therapy with three courses of cyclophosphamide, adriamycin, vincristine, and prednisone (CHOP) every 3 weeks with or without low-dose bleomycin by continuous IV infusion. Responders after three courses were further randomized to 3 weeks of therapy with either high-dose methotrexate (3 gm/m2/week intravenously with leucovorin rescue) or standard-dose methotrexate (30 mg/m2/week orally without rescue). Therapy was concluded with three additional courses of CHOP. Neither the addition of low-dose infusion bleomycin nor the use of high-dose rather than low-dose methotrexate had significant effects on response for patients with DLCL; complete response rates for the four treatment programs ranged from 47% to 51%. Median failure-free survival (FFS) for the entire group of DLCL patients was 12 months; 5-year FFS was 27%. There was no significant effect on FFS from the addition of either low-dose bleomycin to CHOP (5-year FFS: CHOP, 28%; CHOP-B, 26%, P = 0.81), or from the use of different doses of methotrexate (5-year FFS: high-dose, 34%; standard-dose, 33%, P = 0.51). Patients with follicular large cell lymphoma, with or without diffuse areas, had a better FFS (5-year FFS, 47%) than patients with DLCL (5-year FFS, 27%), while the patients with the other histopathologic subtypes of diffuse lymphomas had the poorest FFS (5-year FFS, 16%).

Aged↗
PubMed1990

Augmentation mentoplasty using Mersilene mesh.

Many different materials are available for augmentation mentoplasty. However, the optimal implant material for chin implantation has yet to be found. During the past several years, a number of experienced surgeons have turned to the use of Mersilene mesh. Mersilene mesh is a non-absorbable Dacron polyester fiber that can be conformed easily into layers to achieve tailored dimensions and shape. At the McCollough Plastic Surgery Clinic PA, Birmingham, Ala, 277 patients over a 10-year period underwent chin augmentation with Mersilene mesh implants. The material provides excellent tensile strength, durability, and surgical adaptability. The overall complication rate was 3.2% (nine patients); infection rate, 2.5% (seven patients); and removal secondary to infection, 1.7% (five patients). Based on this 10-year experience, Mersilene mesh remains our material of choice for chin augmentation.

Adult↗
PubMed1990

Management of gastric variceal haemorrhage.

From March 1979 to April 1988 nine patients with hepatic cirrhosis have presented with acute variceal haemorrhage from gastric varices. Of six patients who underwent emergency laparotomy those with modified Child's grade C (n = 3) died within 30 days of surgery. Six patients have been followed for 2 years or longer. In the three patients who underwent under-running of gastric varices alone, two patients developed oesophageal varices at 3 and 14 months, respectively, and in the third patient gastric varices recurred 3 years after surgery. In the remaining three patients, additional left gastric vein ligation was not associated with recurrence of gastric varices or the development of oesophageal varices.

Adult↗
PubMed1990

Platinum-based combination chemotherapy in advanced non-small cell lung cancer: a randomized phase II trial of the Cancer and Leukemia Group B.

The Cancer and Leukemia Group B (CALGB) utilized a randomized phase II trial design to evaluate two cisplatin-based combinations, cisplatin-cytarabine (ara-C) and cisplatin-vinblastine, in 151 patients with advanced non-small cell lung cancer. Patients entered on study had not received prior chemotherapy. Platinum doses were equivalent in the two treatment programs. The total response rate (complete response, partial response, regression of evaluable disease) for the cisplatin-vinblastine group was 22% (16/73). Failure-free survival at six months for this group was 41%, survival at six months was 63%. The cisplatin-ara-C group had a total response rate of 9% (7/78) with a failure-free survival at six months of 14% and a six-month survival of 47%. Severe or life-threatening toxicity was seen in 73% of cisplatin-vinblastine cases and 59% of cisplatin-ara-C patients. Neither regimen is active enough to warrant designation as "standard therapy" for patients with M1 disease.

Aged↗
PubMed1990

2' Deoxycoformycin (pentostatin) for refractory non-Hodgkin's lymphoma: a CALGB phase II study.

Seventy-six eligible patients with relapsed or refractory non-Hodgkin's lymphoma (NHL) were treated with 2'-deoxycoformycin (pentostatin) at a dose of 4 mg/m2 intravenously weekly for three weeks and then every other week for a minimum of five total treatments. All patients had measurable disease, near normal hematologic, renal, and hepatic function, and a performance status of 0 or 1. Severe hematologic toxicity was observed in 13% of patients; severe renal or neurologic toxicity was observed in less than 5% of patients. There were no treatment-related deaths. Objective therapeutic responses were seen in 16% of patients (five complete response [CR] and seven partial response [PR]). However, in three of the patients achieving CR and one patient achieving PR, dexamethasone was employed as an anti-emetic, making the response of these patients to pentostatin difficult to evaluate. There were eight responses (3 CR) in patients with diffuse histologies and four responses (2 CR) in patients with nodular or mixed histologies. Three responses were in patients with a T-cell phenotype. Three of five patients with diffuse well-differentiated lymphoma (IWF A) responded. We conclude that 2' deoxycoformycin is only minimally active at this dose and schedule against refractory or relapsed NHL. The possibility that low grade B- and T-cell malignancies are more sensitive to 2' deoxycoformycin deserves further investigation.

Aged↗
PubMed1990

Indium 111 leucocyte scintigraphy in abdominal sepsis. Do the results affect management?

We have studied the clinical utility of indium 111 autologous leucocyte scintigraphy retrospectively in 45 patients presenting with suspected intra-abdominal sepsis. The sensitivity was 95% (21/22) and the specificity was 91% (21/23). Some 34 of the studies (17 positive and 17 negative) were considered helpful in furthering patient management (76%) and 8, unhelpful (18%). In 3, the study results were misleading and led to inappropriate treatment. Indium 111 scintigraphy, whether positive or negative, provides information in patients with suspected intra-abdominal sepsis upon which therapeutic decisions can be based.

Abdomen↗
PubMed1990

Do nasogastric feeding tubes cause gastro-oesophageal reflux in healthy subjects?

The potential relationship between nasogastric intubation and acid gastro-oesophageal reflux was investigated. Ten healthy volunteers underwent 24h oesophageal pH monitoring following intubation with (i) a pH monitor alone, (ii) a pH monitor plus a Ryles nasogastric tube and (iii) a pH monitor plus a fine-bore nasogastric feeding tube. Neither of the nasogastric intubations were associated with significant reflux.

Journal Article↗
PubMed1990

Impaired nutritive skeletal muscle blood flow in patients with chronic renal failure.

1. The possibility that abnormalities of skeletal muscle may limit the exercise tolerance of patients with chronic renal failure was investigated in patients undergoing regular haemodialysis. 2. Blood flow to the calf, a vascular bed consisting predominantly of skeletal muscle, was measured in six patients before and after exercise and compared with values obtained from 12 control subjects. 3. The patients were limited on exertion and had an abnormal response of calf blood flow to bicycle exercise. Resting calf blood flow was similar in patients and control subjects, but the mean increase in calf blood flow in response to submaximal exercise was 0.55 (SEM 0.12) ml min-1 100 ml-1 in the patients and 1.43 (SEM 0.17) ml min-1 100 ml-1 in the control subjects. The increase after symptom-limited maximal exercise was 1.50 (SEM 0.80) ml min-1 100 ml-1 in the patients and 4.20 (SEM 0.40) ml min-1 100 ml-1 in the control subjects. 4. Skeletal muscle biopsies from eight haemodialysis patients were studied by histochemistry and electron microscopy. 5. Oxidative enzyme activity was increased and there were large subsarcolemmal aggregates of structurally normal mitochondria. Necrotic capillaries were observed as empty basement membrane tubes containing fragments of degenerating endothelium. 6. The changes were compatible with a response to a chronic reduction in skeletal muscle blood flow.

Capillaries↗
PubMed1990

Arterial oxygen saturation during upper gastrointestinal endoscopy: the effects of a midazolam/pethidine combination.

This study was performed to assess the severity and duration of hypoxia during and after prolonged upper gastrointestinal endoscopy. Twenty patients were studied using a non-invasive pulse oximeter. Significant reductions in oxygen saturation were noted during endoscopy and remained below the preexamination level during the one hour period after the examination. This study indicates that pulse oximetry is a useful monitor for detection of hypoxia during and after endoscopy.

Adult↗
PubMed1990

Heparin-associated skin necrosis.

A case of skin necrosis at the sites of injection of subcutaneous heparin is described. The patient went on to develop heparin-induced thrombocytopenia and pulmonary embolism. Review of the previously described cases of heparin-associated skin necrosis reveals that this sequence of events is not uncommon.

Female↗
PubMed1990

Peritoneal mesothelioma.

We report two patients who presented with small bowel obstruction secondary to peritoneal mesothelioma. The difficulties in establishing this diagnosis at an early stage are illustrated. Recent advances in the management of peritoneal mesothelioma are reviewed.

Adult↗
PubMed1990

Use of objects as hammers to open nuts by capuchin monkeys (Cebus apella).

The use of stones as hammers to break open nuts was studied in a captive group of 7 Cebus apella. Only the single adult female and an infant showed no tool use. Tool use significantly reduced the time required to break open the nuts and obtain the kernel and led to fewer nuts being abandoned. Individual differences and social processes surrounding tool use are described. The development of tool use in a juvenile female is documented, along with the same female's novel use of a previously neglected object as a tool and the subsequent use of this object by the other members of the group.

Animals↗
PubMed1990

Randomized, prospective study of nail bed ablation for recurrent ingrowing toenails.

A consecutive series of 31 recurrent ingrowing toenails, which had previously undergone at least two surgical procedures, were recruited to this study over a 1-year period. Patients were randomly allocated to one of two treatment groups. Group A underwent nail bed excision whilst group B had nail bed phenolization in addition to excision. Patients were reviewed 2 weeks and 1 year after operation. Seven toes (41%) in group A developed postoperative infection compared with only one (7%) in group B (P less than 0.01). Recurrent nail spicules occurred in ten patients (59%) in group A and six patients (43%) in group B 1 year after operation. High failure rates for ablation of recurrent ingrowing toenails should encourage greater efforts towards adequate treatment at the first presentation.

Adolescent↗
PubMed1989

Salmonella enteritidis phage type 4 infection of broiler chickens: a hazard to public health.

The pericardial fluids and contents of caeca and spleens from 81 broiler chickens that had been condemmed at processing factories because of macroscopic pericarditis were examined for Salmonella species. 47 (58%) of these chickens yielded S enteritidis phage type (PT) 4. Viable counts of the organism in fluids from 6 of the most severely affected hearts ranged from 10(4) to 10(7) colony-forming units/ml. S enteridis PT4 was also isolated from 8 of 20 fresh chilled chickens on retail sale. No other serotype of Salmonella or phage type of S enteritidis was cultured either from the chickens with pericarditis or from the fresh chilled chicken.

Animals↗
PubMed1989

Laparoscopy, ultrasound and computed tomography in cancer of the oesophagus and gastric cardia: a prospective comparison for detecting intra-abdominal metastases.

We have evaluated the sensitivity, specificity and accuracy of laparoscopy under general anaesthesia, ultrasound and computed tomography (CT) in detecting intra-abdominal metastases in 90 consecutive patients with carcinoma of the oesophagus or cardia. Metastases were histologically confirmed as hepatic in 25 patients, nodal in 35 and peritoneal in nine. All investigations had high specificity (86-100 per cent) for each type of metastasis. Laparoscopy was found to be significantly more sensitive (P less than 0.01; P less than 0.02) and more accurate (P less than 0.01; P less than 0.01) than either ultrasound or CT, respectively, with regard to hepatic status. Although laparoscopy performed best with regard to nodal metastases, this reached statistical significance only when sensitivity of ultrasound was compared (P less than 0.01). Neither ultrasound nor CT detected any peritoneal metastases, although laparoscopy detected eight out of nine, giving a sensitivity of 89 per cent and an accuracy of 98 per cent. There was no morbidity or mortality associated with laparoscopy, which offers a safe, reliable method of determining intra-abdominal status and may obviate the need for surgery in some patients with malignant dysphagia.

Abdominal Neoplasms↗
PubMed1989

Exponential survival trees.

This paper concerns a recursive partitioning algorithm for incomplete survival data. The splitting criterion employed is exponential log-likelihood loss. The method has been integrated into a computer program similar in structure to the commercial package CART. Special features incorporated into the program include a modification to prevent zero hazard estimates during the the cross-validation procedure and a method based on the chi-square distribution for final tree selection. Simulation results demonstrate the program's capability to identify the underlying hazard structure in survival data. An example utilizing data from patients with diffuse large cell lymphoma is presented.

Algorithms↗